阿托伐他汀联合神经节苷脂对脑梗死康复期患者临床疗效及MBP、GAP-43、TGF-β1的影响

Effect of atorvastatin combined with ganglioside on MBP, GAP-43 and TGF - β 1 in convalescent patients with cerebral infarction

目的探讨阿托伐他汀联合神经节苷脂对脑梗死康复期患者临床疗效及髓磷脂碱性蛋白(MBP)、神经生长相关蛋白-43(GAP-43)、转化生长因子β1(TGF-β1)的影响。方法回顾性选取2019年1月至2020年6月北京电力医院收治的150例脑梗死康复期患者,通过治疗方案不同分为对照组和研究组,各75例。对照组患者给予阿托伐他汀治疗,研究组患者给予阿托伐他汀联合神经节苷脂治疗,疗程4周。比较2组患者治疗前、治疗4周后血清神经生长因子水平、神经功能缺损及运动功能以及临床治疗效果和药物不良反应发生情况。结果治疗前2组患者的MBP、GAP-43、TGF-β1水平比较,差异无统计学意义(P> 0.05),治疗4周后2组患者MBP、GAP-43、TGF-β1水平均较治疗前降低,且研究组患者均低于对照组,差异有统计学意义(P <0.05)。治疗前,2组患者的美国国立卫生研究院卒中量表(NIHSS)及Fugl-Meyer评测法(FMA)评分比较,差异均无统计学意义(P> 0.05);治疗4周后,2组患者组内NIHSS水平均较治疗前降低,FMA评分均较治疗前升高(P <0.05),且研究组NIHSS评分低于对照组,FMA评分高于对照组,差异有统计学意义(P <0.05)。研究组治疗有效率(82.7%)高于对照组(74.7%),差异有统计学意义(P <0.05)。研究组不良反应总发生率为12.0%,对照组为10.7%,2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论阿托伐他汀联合神经节苷脂治疗脑梗死康复期患者,可提升患者临床疗效,改善神经生长因子水平、神经功能缺损及运动功能,且不会加重药物不良反应,值得借鉴。

Objective To investigate the clinical effect of atorvastatin combined with ganglioside on patients with cerebral infarction in convalescent stage and the influence of myelin basic protein(MBP),nerve growth associated protein-43(GAP-43)and transforming growth factor-β1(TGF-β1).Methods From January 2019 to June 2020,150 patients with cerebral infarction in the rehabilitation period admitted to Beijing Electric Power Hospital were selected retrospectively,and were divided into a control group and a study group according to different treatment plans,each group 75 cases.They were divided into control group and study group according to different treatment schemes.The control group was treated with atorvastatin,and the study group was treated with atorvastatin combined with ganglioside,4 weeks for treatment.The levels of serum nerve growth factor,neurological deficits and motor function before treatment and 4 weeks after treatment,clinical treatment effects and adverse drug reactions of the two groups were compared.Results There was no significant difference in the levels of MBP,GAP-43 and TGF-β1 between the two groups before treatment(P>0.05).After 4 weeks of treatment,the levels of MBP,GAP-43 and TGF-β1 in the two groups were lower than those before treatment(P<0.05),and the levels of MBP,GAP-43 and TGF-β1 in the study group were lower than those of the control group,the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the scores of the National Institutes of Health Stroke Scale(NIHSS)and Fugl-Meyer Evaluation Method(FMA)between the two groups(P>0.05);after 4 weeks of treatment,the NIHSS scores were lower than those before treatment,and the FMA scores in the two groups were higher than those before treatment(P<0.05),and the NIHSS scores in the study group was lower than those in the control group,and the FMA score were higher than those in the control group,the differences were statistically significant(P<0.05).The effective rate of treatment in the study group(82.7%)was higher than that in the control group(74.7%),and the difference was statistically significant(P<0.05).The total incidence of adverse reactions was 12.0%in the study group and 10.7%in the control group,there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment of atorvastatin combined with gangliosides for patients with cerebral infarction during the rehabilitation period can enhance the clinical efficacy,improve nerve growth factor levels,neurological deficits and motor function,and will not aggravate adverse drug reactions,which is worth learning.